Recent onset double vision is always a concern, and a thorough history and neuro/ophthalmic testing is crucial for a correct diagnosis to be made. Conjecture as to diagnosis on our part, without full knowledge of findings, is to be discouraged.

An absence of neurological signs (yes?), and presence of good fusion response with prism correction (yes?), does seem to be a good predictor of an ABSENCE of intracranial pathology. However, careful motility (eye muscle) examination, and fundus examination (optic nerve) for papilledema and optic atrophy is essential.

As the other doctors have pointed out, an MRI (if done correctly/thoroughly) should rule out space-occupying lesions, but some doctors feel that without any other neurologic symptoms, neuroimaging is not indicated.

Me? I'd get the MRI (can't be to safe), if it comes back negative (probable), I may then recommend bilateral medial rectus recession. Hope this is all helpful information, and everything turns out well.

Kevin Kukla